Provider Demographics
NPI:1952548687
Name:ASTRUM HEARING SOLUTIONS
Entity Type:Organization
Organization Name:ASTRUM HEARING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:III
Authorized Official - Credentials:HIS
Authorized Official - Phone:866-523-6114
Mailing Address - Street 1:3750 HIWAY 95 STE 102
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-8219
Mailing Address - Country:US
Mailing Address - Phone:866-523-6114
Mailing Address - Fax:
Practice Address - Street 1:3750 HIWAY 95 STE 102
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-8219
Practice Address - Country:US
Practice Address - Phone:866-523-6114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD5442237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty